In regional and rural areas of NSW, drinking water is provided by 107 local water utilities serving a total population of some 1.7 million and operating 323 water supply systems. NSW Health exercises public health oversight of these regional water utilities through the NSW Health Drinking Water Monitoring Program, which provides guidance to water utilities on implementing elements of the Australian Drinking Water Guidelines 2004, including drinking water monitoring.

The Water Unit of the NSW Department of Health and local public health units are active in promoting the Program to local water utilities and there is evidence the Program has helped improve the management of regional and rural water supplies. Since the introduction of the current NSW Health Drinking Water Monitoring Program to regional NSW in 2001, there has been a significant improvement in both microbial compliance (from more than 3.5% of samples non-compliant in 2001 to fewer than 2% in 2007, p < 0.001) and adequacy of microbial sampling (from approximately 70% of allocated samples collected in 2001 to more than 95% in 2007, p < 0.001).